A CETP polymorphism improves the diagnostic power of clinical examination in patients with cardiovascular disease.

Aims: Atherosclerosis is common and myocardial infarction, stroke and peripheral arterial occlusive disease are its devastating complications. Accurate risk prediction is urgently needed. We applied molecular tests to improve early clinical identification of patients threatened by a future course of complicated active atherosclerosis. Methods and results: Participants were men and women seeking care in a department of general internal medicine at an academic teaching hospital in Basel, Switzerland, between September 2003 and March 2005. A maximum number of 57 patients with a medical history of proven cardiovascular events and 57 age- and gender-matched patients without cardiovascular events were selected from this cohort of 269 individuals. One of nine common single nucleotide polymorphisms (SNPs) reportedly linked to cardiovascular disease was significantly associated with cardiovascular events (p = 0.02). For CETPrs708272, the allele number per patient predisposing to cardiovascular events improved the discriminating power of clinical phenotypmg for active versus inactive atherosclerosis. The area under the curve of receiver operating characteristic (ROC) for clinical examination alone was 0.627 (95% CI 0.525-0.730, p = 0.02) and increased to 0.672 (95% CI 0.571-0.772, p = 0.002) when the polymorphism was included in the assessment. Conclusions: Information about common SNPs with high impact on the individual cardiovascular risk, such as CETPrs708272, may help to predict an active, symptomatic course atherosclerosis.